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AstraZeneca alternative available to under 40s following revised JCVI guidance

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The Isle of Man will follow the latest advice from the JCVI – the UK's Joint Committee on Vaccination and Immunisation – issued yesterday (7 May 2021).

It recommends that, where available, an alternative to the AstraZeneca COVID-19 vaccine should be offered to those aged between 30 and 39 who do not have an underlying health condition and where the offer of an alternative does not cause a substantial delay in someone being vaccinated.

The JCVI's updated advice follows a further review by the MHRA – the UK's Medicines and Healthcare products Regulatory Agency – on extremely rare and unlikely to occur blood clots (concurrent thrombosis) and low platelet count (thrombocytopenia) following the first dose of the AstraZeneca vaccine.

These reports have also been analysed by the UK Government's independent advisory body, the Commission on Human Medicines and its COVID-19 Vaccines Benefit Risk Expert Working Group, which includes lay representatives and advice from leading haematologists.

The MHRA has not changed its advice on the AstraZeneca COVID-19 vaccine. The regulator noted that the benefits of the vaccine, compared to COVID-19 and its associated risk of hospitalisation and death, continue to outweigh the risks of any vaccine side effects for the vast majority of people.

An initial review in April saw revised guidance issued advising that – as a precaution – it was preferable for those aged under 30, who do not have an underlying health condition that puts them at higher risk of severe COVID-19 disease, to be offered an alternative to the AstraZeneca COVID-19 vaccine where available.

This was because the rare side effects were more common in younger people who are also at lower risk of death and serious illness if they contract COVID-19.

As a result, the majority of Island's supply of the Pfizer COVID-19 vaccine was planned for use for those aged below 30. In the next few days everyone in the Isle of Man who has registered for a COVID-19 vaccine and booked an appointment will have received their first dose, with the focus shifting to second doses.

Minister for Health and Social Care, David Ashford MHK, said:

"This further review by the MHRA has shown the COVID-19 vaccines remain highly effective and substantially reduce the risk of death and severe illness as well as reducing the risk of transmitting the virus to others.

"Serious side effects are extremely rare and, compared to the risk of hospitalisation and death from COVID-19, the benefits of the AstraZeneca vaccine continue to outweigh the risks of any vaccine side effects for the vast majority of people.

"In the UK over 34 million people have received a first vaccine dose and the programme is estimated to have prevented over 10,000 deaths.

"With the pace of our vaccination programme we have already used our current supplies of Pfizer and do not expect to receive more available for first doses until late July. Our focus is now shifting to second doses, but I am conscious that there are still people who have not come forward for their vaccination despite being invited to do so. These individuals will now have to wait for their first dose but I would continue to encourage any adult not yet vaccinated to register."

The Minister added:

"I must emphasise that anyone who has received their first vaccine dose must have a second dose to be fully protected from COVID-19 and the current guidance is that the second dose must be the same brand as the first to ensure effectiveness. If you have had a first dose of AstraZeneca then your second dose must be AstraZeneca."

The Minister continued:

"The JCVI advice is clear. An alternative to AstraZeneca should only be considered where it will not cause a delay to getting vaccinated. Given that we are looking at an almost three month wait for further supplies of Pfizer, I would encourage anyone under 40 who does not yet have an appointment for their first dose of vaccine to think carefully about whether it is right for them to delay."

Anyone aged between 30 and 39 who has an appointment to receive their first dose of AstraZeneca and wishes to wait to rebook for Pfizer at a later date is asked to contact 111.

Forty five per cent of those aged between 30 and 39 in the Isle of Man have already received their first vaccine dose.